Intra-arterial thrombolysis for acute ischemic stroke: Our institutional experience

Abstract

Introduction

The standard treatment for acute ischemic stroke is intravenous (IV) rtPA for patients who can reach the hospital within 3 to 4.5 h. There are case reports, where IA thrombolysis has helped patients in case an IV thrombolysis has failed. We report 14 cases of acute ischemic stroke treated by intra-arterial (IA) thrombolysis.

Materials and Methods

We have retrospectively analyzed 14 cases of acute ischemic stroke treated at our department between December 2008 and October 2011 by intra-arterial thrombolysis. The patients with suspected large vessel occlusion (11 patients) and patients not responding to IV rtPA (3 patients) were considered for the IA thrombolysis.

Results

We achieved complete recanalization (TIMI 3) in 11 patients. One patient had a bleed following the procedure but recovered well during the hospital stay. All the patients were followed up to 90 days. Majority of them have good functional outcome.

Conclusions

Our study suggests that intra-arterial thrombolysis is a feasible option in the subgroup of patients with large vessel occlusion. However, there is a need for a randomized multicentric study to support our results.

Key words

Acute stroke - intra-arterial thrombolysis - rtPA - urokinase

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